上前牙复杂冠折牙龈修整术的疗效评价  

Clinical evaluation of effects of crown lengthening and gingivectomy on maxillary anterior tooth crown fracture

作　　者：李军科[1] 程瑞卿[1] 

机构地区：[1]邢台市眼科医院口腔内科,河北邢台054000

出　　处：《牙体牙髓牙周病学杂志》2010年第1期43-45,共3页Chinese Journal of Conservative Dentistry

摘　　要：目的:评价牙冠延长术与牙龈切除术对外伤导致的上前牙复杂冠折,牙体缺损达龈下的牙龈修整术的临床疗效。方法:选择120例共计160个外伤所致的上颌前牙复杂冠折患牙,术前按断端位于龈下距离分为浅缺损组(88个患牙,距离<2.5 mm)和深缺损组(72个患牙,2.5～4 mm)。两组病例再各随机分为两组,分别采用牙龈切除术或牙冠延长术,观察手术前后不同阶段的牙周探诊深度(PD)、龈沟出血指数(SBI)、牙齿松动度(TM),进行疗效评价。结果:①在浅缺损组,采用牙龈切除术和牙冠延长术,PD、SBI均有显著性改变(P<0.05),TM有增加趋势,牙龈切除术与牙冠延长术比较,PD、SBI无显著性差异(P>0.05)。②在深缺损病例组,两种手术方法在术后2周与术前相比PD、SBI均改善(P<0.05),但术后6个月(修复后)牙龈切除组各项牙周指标均明显加重,而冠延长术组与术后2周相比无显著性差异(P>0.05)。结论:上颌前牙复杂冠折,缺损位于龈下,不侵犯生物学宽度时,可采用牙龈切除术;侵犯生物学宽度时,采用牙冠延长术修整牙龈。AIM： To evaluate the clinical effects of crown lengthening and gingivectomy on complicated maxillaryanterior tooth crown fracture with the fracture below the gumline. METHODS： One hundred and sixty fractured teeth from 120 patients were included in this study. According to the distance between the fracture and the gumline, the teeth were divided into 2 group, the shallow defect group （ 〈2.5 mm） （Group S） and the deep defect group （between 2.5 mm and 4mm） （Group D）. Each group was further divided randomly into crown lengthening and gingivectomy groups. Probing Depth （PD）, gingival sulcus bleeding index （SBI） and tooth mobility （TM） were measured preoperatively and at 2 weeks and 6 months postoperation. RESULTS ： In S group, PD and SBI significantly decreased after both crown lengthening and gingivectomy （P 〈 0.05）, whereas TM increased. There was no significant difference between PD and SBI in crown lengthening and gingivectomy groups （P 〉 0.05 ）. In D group, PD and SBI greatly reduced 2 weeks postoperatively （P 〈 0.05 ）. However, at 6 months postoperation the PD and SBI were markedly higher in gingivectomy group as compared with post-2 week parameters （P 〈 0.05 ）, while in crown lengthening group that remained almost the same as that of 2 weeks postoperation. TM time-dependently increased in both groups. CONCLUSION： Our results indicated that gingivectomy could be used for cases with tooth fracture above the gumline and crown lengthening might be more suitable for cases with tooth fracture under the gumline.

关 键 词：复杂冠折 牙龈切除术 牙冠延长术 生物学宽度 

分 类 号：R781.2[医药卫生—口腔医学]